Blue Balls

blue balls pain

What are blue balls?

Blue balls are medically called epididymal hypertension (EH).  Blue balls refer to testicular pain that occurs when the blood in the genitals is retained after prolonged arousal and is not dissipated by an orgasm.  The condition is generally associated with men who are experiencing delayed ejaculation or reluctant ejaculation.  The main reason for this phenomenon is the long sexual stimulation or arousal condition in which the penis stays erect, but without orgasm or ejaculation to occur. 

During arousal, the sympathetic nervous system is off and there is an increased amount of blood that reaches the scrotum, testicles, and prostate region.  During this process, the muscles in that region shrink.  The purpose of this elevated amount of blood in this area is to maintain an erection during intercourse.  When there is no ejaculation, the blood becomes more oxygen-poor but does not leave the area and in some cases produces a bluish appearing scrotum and hence the slang of Blue Balls is applied to this condition. During the process of vasoconstriction (the constriction of blood vessels, which increases blood pressure), testicles increase their size by 25 percent to 50 percent.

blue balls diseaseThe fastest way to get rid of pain caused by epididymal hypertension is through sexual intercourse.  The process of ejaculation switches on the sympathetic nervous system which helps dissolve the blood in that area and gradually the symptoms disappear over time.  Another way to get relief is from cold water shower or applying cold water to the scrotum.  Applying cold water can increase blood circulation in the body and relieving the pressure.  A severe form of vasoconstriction is called priapism, which requires medical treatment.  Women can also suffer from this phenomenon.  Women’s genitals too experience an increased amount of blood flow during arousal and intercourse which causes congestion.  If the woman does not reach orgasm, she may feel pelvic pressure and sometimes even pain.

Symptoms of blue balls

Blue balls or epididymal hypertension (EH) affects the testicles and may exhibit the following symptoms:

  • Pain
  • Discomfort
  • Heaviness
  • Aching
  • Bluish discoloration of the scrotum.

Causes of Blue balls or epididymal hypertension (EH)

The main cause of blue balls or epididymal hypertension is due to the vasoconstriction in the genitals.  When a man becomes sexually aroused, the arteries that carry blood to the genitals swell, while the veins that leave the genital area become small, allowing less blood to escape.  This infrequent blood flow increases the amount and pressure of blood flow and retains it in the genital area.  

The pressure which is formed is responsible for producing an erection and makes the testes to swell and makes them 25 percent to 50 percent larger than their normal size.  If a climax is attained, the blood vessels quickly will return to their normal size and the amount of pressure in the genitals release and they return to their normal level.  In other cases when a man is aroused and does not have a climax, blood flow in the genitals collects through a process called vasocongestion and may create sensations of aching, heaviness, and discomfort.

blue balls painDue to the long time the blood is trapped in the genitals, the blood is oxygen deprived and the color of the scrotum turns to blue from the accumulation of deoxygenated blood in the testicles. Oxygen-rich blood on the surface of the skin creates a red color, while blood with little oxygen appears blue.  The longer the blood stays in the testes and scrotum without circulating to the heart and lungs, the less oxygen it obtains and the bluer the skin appears.  Epididymal hypertension usually does not last long and often the pain associated with blue balls is minimal.

It is common for men to become frustrated when they get an erection during sexual activity, but do not achieve climax.  Due to this failure to achieve climax can lead to psychological stress and physical discomfort for men.

Other causes of testicular pain

The pain and discomfort in the testicles only when a person is aroused is most likely a result of epididymal hypertension.  Pain occurring in the testes when not aroused may indicate other problems.  Testicular pain can be caused by other diseases that can be localized to the testes or elsewhere in the scrotum.

Other conditions causing testicular pain include:

  • Infection with chlamydia: Chlamydia and gonorrhea infection can cause inflammation of the epididymis causing severe pain to the testicles.
  • Epididymitis (inflammation of the testicles): It is an inflammation of the coiled tube, which is present at the back of the testicle that carries and stores the sperm.  Due to the inflammation, it causes severe pain to the testes.
  • Hydrocele (swelling of the scrotum): Hydrocele is a type of swelling in the scrotum that occurs when fluid collects in the thin sheath surrounding the testicle.  A hydrocele is common in newborns and usually disappears without treatment.  A hydrocele is known to cause pain in the testes.
  • An inguinal hernia: An inguinal hernia is defined as a lump or bulge in the inguinal area.  These inguinal hernias develop when fatty or intestinal tissues protrude through a weakened abdominal wall.
  • Kidney stones: Kidney stones are deposition of minerals that form on the inner lining of the kidneys.  These kidney stones do not cause any problems until they remain in the kidney but can cause serious problems including severe pain when they move out of the kidney to the bladder.
  • Mumps: Mumps or orchitis caused by a bacterial infection most commonly develops from the course of epididymitis, which is an infection of the tube that carries semen out of the testicles. This condition is called as epididymal-orchitis.
  • Retractile testicle: Retractile testicle is a medical condition when a testicle retracts into the abdomen, which occurs in boys.  This condition can cause severe discomfort and pain.
  • Scrotal tumors: Tumor, cysts, spermatocele, epididymitis, and torsion of the epididymal appendix all affect the epididymis and may present as a mass or nodule and are known to cause testicle pain.
  • Spermatocele: A spermatocele is a fluid-filled sac that grows in the epididymis, which is a small tube near the upper testicle that collects and transports sperm. Spermatoceles vary in size and could cause pain if they grow too large.
  • Testicular trauma: Testicular trauma occurs due to an injury to the testicle.  The injury caused to the testicle or scrotum can alter the configuration of these organs.  When the testicle’s tough cover is torn or shattered, blood leaks from the wound and stretches the scrotum until it is tense, and can lead to infection
  • Testicular torsion (twisted testicle): Testicular torsion occurs when a testicle rotates and this, in turn, twists the spermatic cord and alters the blood to the scrotum.  The reduced amount of blood flow may induce severe pain and swelling.
  • Testicular cancer: Testicular cancer is defined as the lump on the testicles. Symptoms of testicular cancer include swelling, pain, and/or lumps in the testicles or groin.
  • Varicocele (enlarged veins in the scrotum): A varicocele is an enlargement of the veins within the loose bag of skin that holds the testicles.

Treatment for blue balls or epididymal hypertension

blue ballsIgnore the problem:  The pain of blue balls is not considered to be harmful and carries no side effects.  There is virtually no medical treatment required for treating blue balls and generally subsides when the problem is ignored.

Do some heavy lifting:  Doing some hard manual labor will help to blow off some steam and it actually works.  Lifting heavy objects as well as pushing them induces a maneuver called Valsalva maneuver, which flexes the internal muscles as during a bowel movement. This, in turn, can release the pressure on the testicles and relieve the pain.

Work out:  Anything that helps divert blood flow should help relieve the pressure off the swollen testicles.  Jogging on the treadmill or doing a few push-ups can help the blood to move to other parts of the body and away from the scrotum.

Refresh the mood:  Changing the mood by concentrating on other aspects and reducing arousal is an easy way to divert the blood flow away from the genitals and provide relief to blue balls.  Ignoring the thoughts which can lead to arousals such as thinking of a family member, taxes, or trouble at work should help in reducing the thoughts of arousal and this, in turn, relaxes the scrotum and releases the pressure off it.

Put an ice pack:  Ice pack is a quick way to cool things down.  Cold reduces swelling and therefore pressure and pain in the scrotum.  It acts a shock to the system, which can help the person get off the arousal mood.

Get a cold shower:  Taking a cold shower again seems to be beneficial.  Taking a cold shower increases the blood circulation in the body.  It also helps the blood which is trapped in the scrotum to release and reducing the pressure on the scrotum.

Facts

  • Medically called as epididymal hypertension
  • May cause bluish discoloration to the testes.

Facts

  • This condition is generally painful.
  • It usually affects men between the age of 15 and 30.

Facts

  • During this condition, the testes swell up to 25-50% bigger.
  • Masturbating or icing the area provides relief.

Related Conditions

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Dos and Don'ts

Dos
  • Immediate relief can be achieved with masturbation.
  • A cold shower can relieve symptoms.
  • Distract your mind into something nonsexual.
  • Slow music can also help.
  • Keep yourself busy with other activities.
Don'ts
  • Hide it from your doctor, if it is persistent.
  • Engage yourself with sexual desires more often.
  • Make a habit of masturbating on a daily basis.

 

 

 

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